Semin intervent Radiol 2002; 19(1): 051-058
DOI: 10.1055/s-2002-25139
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Genitourinary Intervention in Children

Mary B. Schmidt, Charles A. James
  • Department of Radiology, Arkansas Children's Hospital and University of Arkansas for Medical Sciences, Little Rock, Arkansas
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Publikationsverlauf

Publikationsdatum:
17. April 2002 (online)

ABSTRACT

Pediatric nonvascular genitourinary intervention requires the operator to consider pediatric sedation concerns, equipment and catheter and technique modifications because of the small size of the patient, and congenital anomalies. The infant or small child must be kept warm during the procedure. General anesthesia is usually not necessary for drainage procedures or nephrostomy tube placement. Ureteral stenting occurs less frequently in children than in adults but is often used in cases of postsurgical scarring. Shorter and lower profile nephrostomy and drainage tubes improve chances of retention and success. Procedures in the infant and young child, particularly percutaneous nephrostomy and nephrolithotomy, can be quite challenging but may result in preservation of renal parenchyma. Percutaneous stone removal is enabled by flexible small endoscopes, decreased width of tract dilatation, and use of small caliber peel-away sheaths. Percutaneous drainage of a urinoma or instillation of antifungal agents via nephrostomy tube may also be renal preserving. Ultrasound guidance, in conjunction with fluoroscopy, is ideal for percutaneous procedures in children.

REFERENCES

  • 1 Dravid V, Gupta A, Zegel H, Morales A, Rabinowitz B, Freiman D. Investigation of antibiotic prophylaxis usage for vascular and nonvascular interventional procedures.  J Vasc Interv Radiol . 1998;  9 401-406
  • 2 Millward S. Percutaneous nephrostomy: a practical approach.  J Vasc Interv Radiol . 2000;  11 955-964
  • 3 Banner M. Percutaneous nephrostomy. In: Banner M, ed. Radiologic Interventions: Uroradiology Baltimore: Williams & Wilkins 1998: 3-27
  • 4 Koral K, Saker M, Morello F, Rigsby C, Donaldson J. Percutaneous nephrostomy in infants: improved success with two step technique. In: scientific abstracts from the Society of Cardiovascular and Interventional Radiology meeting, 2000: 269
  • 5 Jackman S V, Hedican S P, Peters C A, Docimo S G. Percutaneous nephrolithotomy in infants and preschool children: experience with a new technique.  Urology . 1998;  52 697-701
  • 6 Ahmed S, Borghol M, Hugosson C. Urinoma and urine ascites secondary to calyceal perforation in neonates with posterior urethral valves.  Br J Urol . 1997;  79 991-992
  • 7 Bryant K, Maxfield C, Rabalais G. Renal candidiasis in neonates with candiduria.  Pediatr Infect Dis J . 1999;  18 959-963
  • 8 Yoo S Y, Namkoong M K. Acute renal failure caused by fungal bezoar: a late complication of Candida sepsis associated with central catheterization.  J Pediatr Surg . 1995;  30 1600-1602
  • 9 Mansi M K, Alkhudair W K. Conservative management with percutaneous intervention of major blunt renal injuries.  Am J Emerg Med . 1997;  15 633-637
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